Efficacy Of Pulsed Radiofrequency On Cervical 2-3 Posterior Medial Branches In Treating Chronic Migraine

Objective : To perform a systematic review on occipital nerve stimulation in the treatment of migraine. Then we investigated the efficacy and safety of PRF on cervical 2-3 posterior medial branches in treating chronic migraine.Methods:In the systematic review, literatures were searched and reviewed in the data base. The characteristics and the levels of evidence were all recorded. After the extracting of data, we evaluated the efficacy and complications, respectively. In the second part, we presented a case report about the chronic thoracic pain with spontaneous muscle contraction treated by pulsed radiofrequency. In the third part, a randomized, double-blind and controlled clinical trial was performed. This study included 40 subjects with chronic migraine, who were randomly divided into the treatment and the sham group. Pain intensity, headache duration(days), the Migraine Disability Assessment Questionnaire(MIDAS), and aspirin dose taken by patients were evaluated at 1, 2, and 6 months after the intervention. Side effects were observed from the time of treatments and throughout the 6-month follow-up periodResults: 10 researches were enrolled in the systematic review,, including 5 randomized controlled trials and 5 cases series. Occipital nerve stimulation in the treatment of migraine could relieve pain intensity and headache duration. However, the efficacy was limited in randomized controlled trials, and the average incidence of complications was 66%. In the second part, the patient received good efficacy in 2 years follow-up. In the third part, pain intensity, pain duration, dose of analgesic taken by patients and the quality of life were significantly improved. In addition, no serious complication was reported in the follow-up period.Conclusion : The treatments on trigemino-cervical complex might alleviate symptoms of migraine. Pulse frequency could bring benefits to the patients with chronic migraine, and pulse radiofrequency was more minimally invasive and safer compared to occipital nerve stimulation...